Citation Nr: 9805726
Decision Date: 02/26/98 Archive Date: 03/20/98
DOCKET NO. 96-38 711 ) DATE
)
)
On appeal from the Department of Veterans Affairs Medical &
Regional Office Center in Sioux Falls, South Dakota
THE ISSUE
Entitlement to service connection for residuals of dental
trauma.
REPRESENTATION
Appellant represented by: Disabled American Veterans
ATTORNEY FOR THE BOARD
Andrew P. Hinton, Associate Counsel
INTRODUCTION
The veteran had active service from January 1968 to November
1971.
This matter has come before the Board of Veterans' Appeals
(Board) on appeal from a May 1996 rating decision of the
Sioux Falls, South Dakota, Department of Veterans Affairs
(VA) Medical and Regional Office Center (M&ROC).
CONTENTIONS OF APPELLANT ON APPEAL
The veteran essentially contends that during service he fell
and broke tooth number 9, and currently has residuals from
that trauma. Therefore, a favorable determination is
requested.
DECISION OF THE BOARD
The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991 & Supp. 1997), has reviewed and considered
all of the evidence and material of record in the veteran's
claims file. Based on its review of the relevant evidence in
this matter, and for the following reasons and bases, it is
the decision of the Board that service connection for
residuals of dental trauma involving tooth number 9 is
warranted.
FINDING OF FACT
The veteran has residuals of dental trauma, which is
attributable to the veteran's active service.
CONCLUSION OF LAW
Residuals of dental trauma was incurred during active
military service. 38 U.S.C.A §§ 1110, 5107(b) (West 1991);
38 C.F.R. §§ 3.381, 17.161 (1997).
REASONS AND BASES FOR FINDING AND CONCLUSION
As a preliminary matter, the Board finds that the veteran's
claim is "well grounded" within the meaning of 38 U.S.C.A. §
5107(a) (West 1991). See Murphy v. Derwinski, 1 Vet.App. 78,
81 (1990); Gilbert v. Derwinski, 1 Vet.App. 49, 55 (1990).
That is, the Board finds that the veteran's claim is not
implausible when his contentions and the evidence of record
are viewed in the light most favorable to that claim. The
Board is also satisfied that all relevant facts have been
properly and sufficiently developed.
Service medical records show evidence that in May 1971, the
veteran underwent treatment of tooth number 9, involving a
Mesial Incisal Lingual (MIL) cap. The veteran claims that
this was necessitated by his injury in which he broke his
front tooth, number 9.
Private medical records show further treatment to tooth
number 9, involving placement of a microband crown, in May
1972.
A January 1997 informal medical opinion from the VA medical
center in Sioux Falls, South Dakota stated that the examiner
had reviewed the dental record. That examiner opined that
the repair done to tooth number 9 in May 1971 could well have
been needed because of trauma to the tooth, even though this
was not specifically mentioned in the dental record.
The veteran testified at a July 1997 hearing that during
service in May 1971, while on liberty, he fell and hit his
tooth on a bar and broke it in half. He went back to his
ship where a dentist put a cap on it with one pin. After
leaving service, in May 1972, he had a permanent crown put on
the tooth by a private dentist.
Service connection may be granted for disability resulting
from a disease or injury that was incurred in or aggravated
by active service. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38
C.F.R. § 3.303 (1997). Service connection may be granted for
dental conditions of individual teeth, shown to have been
incurred in or aggravated by service. 38 C.F.R. § 3.381(a)
(1997). That is, each missing or defective tooth, and each
disease of the investing tissues, will be considered
separately when determining this benefit. Id.
The furnishing of treatment or a prosthesis for
noncompensable dental conditions during service will not be
considered per se as aggravation of a dental condition shown
to have existed prior to entrance into active service. Teeth
noted at entry into active service as carious restorable will
not be held as service connected, either directly or by
aggravation, notwithstanding enlargement of the original
cavity or development of additional cavitation on the same or
another surface. Service connection by aggravation will be
conceded in such teeth, carious restorable at entry into
service, whether or not filled, but which necessitate
extraction after entry into active service. 38 C.F.R. §
3.381(b).
As to each noncompensable service-connected dental condition,
a determination will be made as to whether it was due to a
combat wound or other service trauma. 38 C.F.R. § 3.381(e).
The significance of a finding that a noncompensable service-
connected dental condition is due to dental trauma, as
opposed to other causes, is that VA provides any reasonably
necessary dental treatment, without time limitations, for
conditions which are attributable to the service trauma,
whereas other service-connected noncompensable dental
conditions are typically subject to limitations of one-time
treatment and timely application after service. See U.S.C.A.
§ 1712; 38 C.F.R. § 17.161 (1997) (formerly designated as 38
C.F.R. § 17.123).
Treatable carious teeth, replaceable missing teeth, dental or
alveolar abscesses, periodontal disease (pyorrhea), and
Vincent's stomatitis are not disabling conditions, and may be
considered service connected solely for the purpose of
determining entitlement to dental examinations or outpatient
dental treatment under the provisions of 38 C.F.R. § 17.160
(1997) (formerly designated as 38 C.F.R. § 17.120) or §
17.161. 38 C.F.R. § 4.149. Thus, the only purpose of
service connecting noncompensable, nontrauma-related dental
conditions is if a veteran would be entitled to or eligible
for VA dental examinations or VA dental treatment.
Conversely, if he is not entitled to such examinations or
treatment by the VA, service connection is not warranted.
In this case, the evidence shows that the veteran underwent
repair of tooth number 9 during service. There is no
clinical evidence to show that this was due to any condition
pre-existing service, or due to non-trauma causes. The
veteran has stated that the treatment was due to trauma at
the time which caused damage to tooth number 9. Although a
lay person is not competent to make a medical diagnosis or to
relate a medical disorder to a specific cause, a lay person
is competent to provide evidence on the occurrence of
observable symptoms during and following service. . See
Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992), Savage v.
Gober, No. 94-503, slip op. at 14 (U. S. Vet. App. Nov. 5,
1997). Thus the veteran is competent to attest to his
observation that his tooth was broken in half, since this
damage could be observed either visually or by tactile
sensation.
The evidence required to warrant a grant of disability
benefits does not have to be conclusive. The question is
whether the evidence supports the claim or is in relative
equipoise, with the veteran prevailing in either event, or
whether a fair preponderance of the evidence is against the
claim, in which case the claim is denied. 38 U.S.C.A. §
5107(b) (West 1991); Gilbert v. Derwinski, 1 Vet.App. 49, 55
(1990).
Service medical records do document that a MIL cap was placed
on tooth number 9 during service. The veteran had further
work on the tooth soon after service. There is no medical
notation that the veteran’s teeth received any extensive
treatment for poor dental hygiene or any dental disease
during service. The VA medical opinion was that the repair
performed on tooth number 9 during service could well have
been required because of trauma, even if the record did not
specifically indicate trauma. In resolving all reasonable
doubt in favor of the veteran, the Board concludes that the
veteran has residuals of dental trauma involving tooth number
9 which is attributable to service.
ORDER
Entitlement to service connection for residuals of dental
trauma is granted.
BRUCE KANNEE
Member, Board of Veterans' Appeals
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991 & Supp. 1997), a decision of the Board of Veterans'
Appeals granting less than the complete benefit, or benefits,
sought on appeal is appealable to the United States Court of
Veterans Appeals within 120 days from the date of mailing of
notice of the decision, provided that a Notice of
Disagreement concerning an issue which was before the Board
was filed with the agency of original jurisdiction on or
after November 18, 1988. Veterans' Judicial Review Act,
Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The
date which appears on the face of this decision constitutes
the date of mailing and the copy of this decision which you
have received is your notice of the action taken on your
appeal by the Board of Veterans' Appeals.
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